Total approved v. Total funded positions

[medhacker]

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Can anyone explain this to me?

What does this really mean?


I ask because I am looking at a program that claims to have 6 approved 3 funded, yet they currently have 2 OGME 6 filled positions and 4 OGME 7 filled positions, does anyone know? thanks.

 

[medhacker]

Can anyone explain this to me?

What does this really mean?


I ask because I am looking at a program that claims to have 6 approved 3 funded, yet they currently have 2 OGME 6 filled positions and 4 OGME 7 filled positions, does anyone know? thanks.

anyone??

 

[misparas]

This is for residency spots right? I have a 100% guess.

6 approved, means that they may have 6 students. 3 funded, means that they can only pay 3 of the 6 residents.

Anyone????

 

[medhacker]

This is for residency spots right? I have a 100% guess.

6 approved, means that they may have 6 students. 3 funded, means that they can only pay 3 of the 6 residents.

Anyone????

Ouch! so 3 are working for free?

 

[misparas]

That's my guess?????

 

[OnMyWayThere]

Ouch! so 3 are working for free?

Yes

 

[medhacker]

Yes

This is like so unbelievable!

serious, I never would have expected this. You either then must have a working spouse, be wealthy, wealthy parents willing to support you or a similar arrangement I guess...

 

[OnMyWayThere]

This is like so unbelievable!

serious, I never would have expected this. You either then must have a working spouse, be wealthy, wealthy parents willing to support you or a similar arrangement I guess...

Or take out more loans 😱

 

[SigPi]

Or take out more loans 😱

There's no way. I'm willing to bet that programs only take the number of residents that they can pay (ie the funded # is the number of residents pre year, not the approved). I would suspect that the "approved" positions is just the AOA saying, "yes, you have the resources and ability to take X number of residents into your program" and the funded positions are the ones they can afford to support. I just can't believe that anyone anywhere, outside of some non-US FMG (which if were talking DO doesnt even apply here) trying to get into the country would even dream of working like a dog (80+ hours/week) for 3-7 years and not getting paid --or even worse, having TO PAY for such punishment.

 

[OSUdoc08]

"Total approved" means how many the AOA has approved. This may or may not correlate with the actual number of residents. "Total funded" means the actual number of residents that the program will accept. If more funding becomes available, the residency can expand up to the total approved.

 

[OnMyWayThere]

The competitive residencies have residents working like dogs for free. We had resident directors at my school the other day and this was one of my questions as well - for example, they said the non-funded derm is just as competitive as the funded.

 

[SigPi]

The competitive residencies have residents working like dogs for free. We had resident directors at my school the other day and this was one of my questions as well - for example, they said the non-funded derm is just as competitive as the funded.

Horrible. If this is the case why doesnt the program elimate funding for all its competitive programs? If there is such an abundance of applicants willing to volunteer 80+ hours out of their week, why pay any of the residents at all?

 

[medhacker]

Horrible. If this is the case why doesnt the program elimate funding for all its competitive programs? If there is such an abundance of applicants willing to volunteer 80+ hours out of their week, why pay any of the residents at all?

I think it has to do with fed. regulations, a minimum number MUST be funded.

 

[OnMyWayThere]

They said it has something to do with state funding. I guess the hospitals aren't paying out of their pocket maybe? - So it sounds like it works like this: AOA approves 8 positions, but the state only funds 4 of them.

 

[CatsandCradles]

I think it has to do with fed. regulations, a minimum number MUST be funded.

People are so much workaholics that they choose to not see that as discrimination? Damn.

To those people out there who aren't getting paid during residency: You got sheer guts and perseverance 👍

Does anyone know how common this is?

 

[scpod]

I think it has to do with fed. regulations, a minimum number MUST be funded.

Actually, there is a cap on the number of funded positions because Medicare pays for resident's salaries through:

"direct and indirect medical education payments to teaching hospitals. The direct, graduate medical education (GME) payments are for the direct costs of residency programs (resident stipends, salaries for teaching physicians, and related overhead expenses for running the program). Medicare spends about $2 billion per year on GME.The IME adjustment is apercentage add-on to the PPS payment rates for teaching hospitals, and was established torecognize the higher patient care costs of teaching hospitals. Both types of payments rise withthe number of residents a hospital trains."

The cap stops hospitals from getting more funds from Medicare (i.e. the government). The paymet amount per resident is $70,000.00 and is adjusted upward by a formula for GME an IME.

In addition, "Hospitals may train more residents than the cap for their facility, but when they do so, they receive no additional Medicare payments." If they want to use their own money, they can. They can also use the funds for any physician training use they desire, and they can give any amount to the resident for a salary that they desire.

 

[medhacker]

Actually, there is a cap on the number of funded positions because Medicare pays for resident's salaries through:

"direct and indirect medical education payments to teaching hospitals. The direct, graduate medical education (GME) payments are for the direct costs of residency programs (resident stipends, salaries for teaching physicians, and related overhead expenses for running the program). Medicare spends about $2 billion per year on GME.The IME adjustment is apercentage add-on to the PPS payment rates for teaching hospitals, and was established torecognize the higher patient care costs of teaching hospitals. Both types of payments rise withthe number of residents a hospital trains."

The cap stops hospitals from getting more funds from Medicare (i.e. the government). The paymet amount per resident is $70,000.00 and is adjusted upward by a formula for GME an IME.

In addition, "Hospitals may train more residents than the cap for their facility, but when they do so, they receive no additional Medicare payments." If they want to use their own money, they can. They can also use the funds for any physician training use they desire, and they can give any amount to the resident for a salary that they desire.

Sure, most of us know this, but it still does not answer SigPis question though 🙂

 

[scpod]

Sure, most of us know this, but it still does not answer SigPis question though 🙂

I thought that was answered, but to spell it out:


"If there is such an abundance of applicants willing to volunteer 80+ hours out of their week, why pay any of the residents at all?"

Because hospitals actually make a profit by training residents. Medicare pays over $100,000.00 per year for each resident. Medicaid also contributes (except in Alaska, Idaho, Illinois, Montana, South Dakota), as well as the VA, the DoD, and several others in smaller amounts. Every ten residents trained brings in over a million dollars for the hospital and they don't give anywhere near that much to the residents. But, if they didn't give them some money, the residents wouldn't work there, and the funding (based on a three year average of the number of house staff) would dry up. Besides, I've heard rumors of "unpaid" residents, but I've never actually met one. I bet that I never will either 🙂

 

[SigPi]

if they didn't give them some money, the residents wouldn't work there, and the funding (based on a three year average of the number of house staff) would dry up.

Not according to one of the last posters. He/She says that the non-funded derm spot is just as competitive as the funded one. read:

"The competitive residencies have residents working like dogs for free. We had resident directors at my school the other day and this was one of my questions as well - for example, they said the non-funded derm is just as competitive as the funded."

Besides, I've heard rumors of "unpaid" residents, but I've never actually met one. I bet that I never will either 🙂

Ditto. Granted I only have ties to one program which is an MD teaching hospital --so i'm not speaking from great wealth of diverse experience, but i agree with you.

 

[scpod]

Not according to one of the last posters. He/She says that the non-funded derm spot is just as competitive as the funded one. read:

"The competitive residencies have residents working like dogs for free. We had resident directors at my school the other day and this was one of my questions as well - for example, they said the non-funded derm is just as competitive as the funded."

Then they have to be part of the less than 20% of residencies that are not approved by the ACGME, because they would not meet the Institutional Responsibilities, some of which are:

"Financial Support for Residents

Sponsoring and participating institutions should provide all residents with appropriate financial support and benefits to ensure that residents are able to fulfill the responsibilities of their educational programs...


Professional liability insurance:

The Sponsoring Institution must ensure that residents in ACGME-accredited programs are provided with professional liability coverage for the duration of training...


Health and disability insurance:

The Sponsoring Institution must provide hospital and health insurance benefits for the residents and their families. The Sponsoring Institution must also provide access to insurance to all residents for disabilities resulting from activities that are part of the educational program..."

Couldn't meet those requirements without spending money on the residents, could you?

 

[DermpathDO]

I thought that was answered, but to spell it out:


"If there is such an abundance of applicants willing to volunteer 80+ hours out of their week, why pay any of the residents at all?"

Because hospitals actually make a profit by training residents. Medicare pays over $100,000.00 per year for each resident. Medicaid also contributes (except in Alaska, Idaho, Illinois, Montana, South Dakota), as well as the VA, the DoD, and several others in smaller amounts. Every ten residents trained brings in over a million dollars for the hospital and they don't give anywhere near that much to the residents. But, if they didn't give them some money, the residents wouldn't work there, and the funding (based on a three year average of the number of house staff) would dry up. Besides, I've heard rumors of "unpaid" residents, but I've never actually met one. I bet that I never will either 🙂

Never met an unpaid resident??? Just wait.. if the Feds do what they want to do in congress, it will be a reality. There will be more unpaid positions and people will end up having to support themselves thru thier residency years. Medicine will once more become a true apprenticeship, out of the 1700's.
I did a dermatopathology fellowship and had to pay for it out of my own funds, because of the competition for positions. I could not get a fellowship the regular way, and ended up paying over 10 K to Ackerman. That meant I not only paid for the program but had to support my self for the year. I was not the only, mind you. Right now that type Dermpath fellowship is declining, but some other residency programs and fellowships are extending that option to resdients.

 

[letsrun4it]

Man that'd be awesome if I ended up getting my dream residency (urology) because I was the only DO resident in the country who didn't need the money.

 

[medhacker]

As unbelievable as it may sound
there are residents out-there doing their residence without pay 😱